Epidemiology and diagnosis of pleural tuberculosis in a low incidence country with high rate of immigrant population : A retrospective study
Macías, Antonio (Hospital Universitari Vall d'Hebron)
Sánchez-Montalvá, Adrián (Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC))
Salvador, Fernando (Hospital Universitari Vall d'Hebron)
Villar, A. (Hospital Universitari Vall d'Hebron)
Tórtola Fernández, María Teresa (Hospital Universitari Vall d'Hebron)
Saborit, Núria (Hospital Universitari Vall d'Hebron)
Molina Romero, Israel (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Data:	2019
Resum:	Background: The confirmatory diagnosis of pleural tuberculosis (pTB) remains challenging. The aim of this study was to describe the clinical and epidemiological characteristics of pTB patients and assess the yield of different diagnostic procedures in a low burden country with a high rate of immigrant population. Methods: All adult patients with pTB between 2007 and 2014 were studied retrospectively. Results: One hundred and three out of 843 patients with tuberculosis had pTB. Fifty-three (54. 1%) were male, and the median age was 45 years (range 18-87 years). Fifty-two (50. 49%) patients were immigrants. A confirmed diagnosis was reached in 16 patients (15. 5%) by microbiological studies of pleural effusion. Lung involvement was demonstrated by sputum smear microscopy in 13/49 (26. 5%), sputum GeneXpert MTB/RIF test in 13/20 (65%), and sputum culture in 16/37 (43. 2%). High-resolution computed tomography (CT) showed lung involvement in 47. 7% of the patients. The cure rate was 91. 3% at the 1-year follow-up. Three patients died, all of them within the first month after diagnosis. Conclusions: The detection of lung involvement increased by two-fold when lung CT was used; this correlated with the likelihood of finding a positive microbiological result on sputum sample testing. Pleural microbiological studies had a low diagnostic yield, and sputum could have a complementary role.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Immigrant population ; Pleural tuberculosis ; Tuberculosis diagnostic tools
Publicat a:	International journal of infectious diseases, Vol. 78 (january 2019) , p. 34-38, ISSN 1878-3511

DOI: 10.1016/j.ijid.2018.10.005
PMID: 30449728

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